Special Article
A Randomized Trial of Care in a Hospital Medical Unit Especially Designed to Improve the Functional Outcomes of Acutely Ill Older Patients
N Engl J Med 1995; 332:1338-1344May 18, 1995
- Abstract
Background
Older persons who are hospitalized for acute illnesses often lose their independence and are discharged to institutions for long-term care.
Methods
We studied 651 patients 70 years of age or older who were admitted for general medical care at a teaching hospital; these patients were randomly assigned to receive usual care or to be cared for in a special unit designed to help older persons maintain or achieve independence in self-care activities. The key elements of this program were a specially prepared environment (with, for example, uncluttered hallways, large clocks and calendars, and handrails); patient-centered care emphasizing independence, including specific protocols for prevention of disability and for rehabilitation; discharge planning with the goal of returning the patient to his or her home; and intensive review of medical care to minimize the adverse effects of procedures and medications. The main outcome we measured was the change from admission to discharge in the number of five basic activities of daily living (bathing, getting dressed, using the toilet, moving from a bed to a chair, and eating) that the patient could perform independently.
Results
Twenty-four patients in each group died in the hospital. At the time of discharge, 65 (21 percent) of the 303 surviving patients in the intervention group were classified as much better in terms of their ability to perform basic activities of daily living, 39 (13 percent) as better, 151 (50 percent) as unchanged, 22 (7 percent) as worse, and 26 (9 percent) as much worse. In the usual-care group, 40 (13 percent) of the 300 surviving patients were classified as much better, 33 (11 percent) as better, 163 (54 percent) as unchanged, 39 (13 percent) as worse, and 25 (8 percent) as much worse (P = 0.009). The difference between the groups remained significant (P =0.04) in a multivariable model in which we controlled for potentially confounding base-line characteristics of the patients. Lengths of stay and hospital charges were similar in the two groups.
Fewer patients assigned to the intervention group were discharged to long-term care institutions (43 patients [14 percent], as compared with 67 patients [22 percent] in the usual-care group; P = 0.01). Among the 493 patients discharged to private homes, similar proportions (about 10 percent) in the two groups were admitted to long-term care institutions during the three months after discharge.
Conclusions
Specific changes in the provision of acute hospital care can improve the ability of a heterogeneous group of acutely ill older patients to perform basic activities of daily living at the time of discharge from the hospital and can reduce the frequency of discharge to institutions for long-term care.
Media in This Article
Figure 1
Change in Patients' Ability to Perform Basic Activities of Daily Living from Admission to Discharge and from Two Weeks before Admission to Discharge, According to Treatment Group.Table 1
Key Elements and Illustrative Features of the Intervention Program.Article Activity
- Article
There is heightened interest today in improving the outcomes in a variety of groups of patients.1-3 Most recent efforts to improve patients' outcomes, however, have focused on specific diseases,4,5 treatments,6-8 or behavior of physicians.9,10 We evaluated a clinical system of care designed to improve overall outcomes in a heterogeneous group of older adults who were hospitalized for acute illnesses.
Patients 65 years of age or older account for 31 percent of acute care hospital admissions in the United States and 45 percent of hospital expenditures for adults.11 These older patients are at high risk for loss of independence and institutionalization.12-15 Many interventions designed to improve the outcomes of acutely ill elderly patients have had disappointing results.15-21
We used complementary principles of quality improvement and comprehensive geriatric assessment to develop a new system of care for acutely ill older patients in our hospital.3,22 This program, which we call Acute Care for Elders, is designed to help patients maintain or achieve independence in basic activities of daily living through the combined effects of four key elements: a specially designed environment, patient-centered care, planning for discharge, and review of medical care (Table 1Table 1
Key Elements and Illustrative Features of the Intervention Program.).22 In order to carry out the specific nursing protocols and to facilitate the work of an interdisciplinary team, our teaching hospital instituted this program in a single 14-bed unit.Methods
From November 1990 through March 1992, we compared the outcomes of patients treated in this special unit with those of patients who received usual care at the University Hospitals of Cleveland, a private, nonprofit teaching hospital affiliated with Case Western Reserve University that has 874 beds.
During the study period, 1794 patients who were 70 or older were admitted for general medical care. Patients who were admitted to a specialty unit (e.g., intensive care, cardiology–telemetry, or oncology) were ineligible for the study (n = 2067). We randomly assigned 651 of the 1794 eligible patients either to the Acute Care for Elders program (n = 327) or to usual care (n = 324) in another general medical unit; the remaining 1143 eligible patients were not enrolled in the study because beds were not available in both the intervention and usual-care units at the time of their admission. Assignment according to computer-generated random numbers was performed at the time of admission by the admitting clerk. Informed consent was obtained orally from patients or their proxies (usually family members), according to procedures approved by the hospital's institutional review board.
Patient Care
In both the intervention and usual-care units, each patient was assigned a primary nurse, two resident physicians, and an attending physician. The intervention and usual-care units had the same hospital-supported staff-to-patient ratios (roughly one budgeted position for a registered nurse for each two beds) and used the same hospital-wide support services (for example, social work, physical therapy, and nutrition). Extramural grant support provided funds for increases in hours worked in the intervention unit by the medical and nursing directors, social worker, physical therapist, occupational therapist, and dietitian; these fractional increases totaled less than one additional full-time person per year. Under the leadership of the medical and nursing directors, the primary nurse assigned to each patient in the intervention group was responsible for assessing the patient's specific needs daily and implementing protocols for the prevention of disability and for rehabilitation.
Usual care consisted of services provided by physicians and nurses in other acute care medical units. The staff of the intervention unit was not involved in the care of patients receiving usual care, and none of the four elements of the program were implemented in usual-care units. However, attending physicians and resident physicians provided care to patients in both the intervention and usual-care groups.
Sources of Data
Data were obtained by means of interviews and from medical records. On admission, interviews were attempted with each patient, the patient's primary nurse, and a family member or other care giver. The patient and nurse were also interviewed at the time of discharge, and the patient and a family member or care giver were contacted three months after discharge. The interview covered sociodemographic characteristics, the ability to function in performing activities of daily living,23,24 the ability to walk, overall health status, the items on a geriatric depression scale,25 and the first 21 items of the Mini–Mental State Examination.26 The five basic activities of daily living that were included in the study were bathing, dressing, using the toilet, moving from a bed to a chair, and eating23; continence was not included because it is not reported as reliably as the other self-care activities.27 The seven instrumental activities of daily living were shopping, cooking, performing household chores, using transportation, managing money, managing medication, and using the telephone.24 On admission, patients and family members were asked about the patients' functional status and overall health two weeks before admission and at the time of admission. Three months after discharge, information was obtained about any stays in long-term care facilities, readmissions to a hospital, and health care services by paid providers at home.
All interviews were conducted by research assistants who were not involved in patient care. These interviewers received standardized training consisting of a written protocol, scripted scenarios, role playing, and observed interviews. Standardization of interviews was maintained during the study by weekly reviews of interview procedures. Interviewers were not blinded to the patients' group assignments. Interrater reliability for data obtained by the interviewers was assessed for 10 hospitalized patients (1.5 percent). The mean kappa statistics were 0.98 for the basic activities of daily living, 0.94 for the instrumental activities of daily living, 0.96 for the mental-status items, and 0.99 for items related to depression.
Clinical data were obtained from medical records. These included the reason for hospitalization,28 the Charlson comorbidity score,29 and the Acute Physiology and Chronic Health Evaluation (APACHE) II score30 on the day of admission.
Data on each patient's hospital charges as reported to the Health Care Financing Administration on the Universal Bill-1982, a standard billing form, were obtained from the hospital. Actual hospital costs, as estimated by the hospital's cost-accounting system, were available for 601 patients and correlated highly with charges (r = 0.96). The results of analyses of hospital costs and charges were similar and are not reported separately. We estimated the cost of the additional staff time paid for by the grant and the capital costs of special features of the intervention unit, which were not included in hospital reports of charges or costs.
Missing Data
Interview data were obtained primarily from the patients; 461 (71 percent) were interviewed on admission, 403 of the 603 surviving patients (67 percent) at discharge, and 328 of the survivors (63 percent) three months after discharge. When information about function was not available from the patients, data from proxy respondents were used; the primary nurse was the source of proxy data obtained at admission and discharge, and a family member or care giver was the source of preadmission and post-discharge data. Only patients' reports were used for the assessment of mental status and mood.
Statistical Analysis
The main outcome variable was the change from admission to discharge in the number of basic activities of daily living that the patients could perform independently. The patient's functional status at discharge was classified as better if the number of activities he or she could perform independently increased from admission to discharge, and worse if this number decreased. Changes from two weeks before admission to discharge were calculated similarly.
We examined differences between the intervention and usual-care groups in base-line characteristics, main end points and other outcomes at discharge, hospital charges and length of stay, and outcomes after discharge. Differences between the groups in the change in the ability to perform activities of daily living independently were evaluated with the chi-square test for linear trend.31 The results of ridit analyses32 confirmed those of the chi-square tests for linear trend and are not reported separately. We used the Wilcoxon rank-sum test to assess differences in continuous variables and the chi-square test for categorical variables, with the modification for linear trend when appropriate.31 The consistency of differences between the intervention and usual-care groups was examined in subgroups defined by several clinical characteristics: age, ability to perform basic and instrumental activities of daily living two weeks before admission, comorbidity score, and APACHE II score at admission. Stratified and multivariable ordinal logistic-regression analyses were used to control for potentially confounding factors.31,33 All statistical tests were two-sided, with P = 0.05 as the criterion to indicate statistical significance.
Results
On admission, the patients randomly assigned to the intervention group were similar to those assigned to receive usual care in most sociodemographic characteristics, health-status measures, chief reasons for admission, and coexisting illnesses (Table 2Table 2
Characteristics of the 651 Patients on Admission to the Hospital.). Forty-eight of the 651 patients (7 percent) died in the hospital — 24 patients each in the intervention and usual-care groups.Outcomes at Discharge
At the time of hospital discharge, 65 (21 percent) of the 303 surviving patients in the intervention group were classified as much better in terms of their ability to perform basic activities of daily living, 39 (13 percent) as better, 151 (50 percent) as unchanged, 22 (7 percent) as worse, and 26 (9 percent) as much worse. In the usual-care group, 40 (13 percent) of the 300 surviving patients were classified as much better, 33 (11 percent) as better, 163 (54 percent) as unchanged, 39 (13 percent) as worse, and 25 (8 percent) as much worse (P = 0.009) (Figure 1Figure 1
Change in Patients' Ability to Perform Basic Activities of Daily Living from Admission to Discharge and from Two Weeks before Admission to Discharge, According to Treatment Group.). The findings were similar (P = 0.009) in an analysis limited to the 382 patients who provided complete information about their functional status at both admission and discharge.The mean numbers of basic activities of daily living that could be performed independently at hospital discharge were 3.6 for the intervention group and 3.3 for the usual-care group (P =0.05). At discharge, the intervention group also had a higher level of function in the basic activities of daily living than they did two weeks before discharge (P =0.05) (Figure 1). Thirty-six (12 percent) of 297 patients in the intervention group were better or much better, 171 (58 percent) had no change, and 90 (30 percent) were worse or much worse, as compared with 16 (6 percent) of 285 patients in the usual-care group who were better or much better, 168 (59 percent) who had no change, and 101 (35 percent) who were worse or much worse.
Table 3Table 3
Change from Hospital Admission to Discharge in the Ability to Perform Basic Activities of Daily Living among the 603 Patients Who Survived to Hospital Discharge. shows the changes from hospital admission to discharge in the number of activities of daily living that could be performed independently by different groups of patients. In the intervention group, benefits were seen for patients less than 80 years old (P = 0.03), those who were able to perform independently fewer than five basic activities of daily living two weeks before admission (P = 0.04), and those with APACHE II scores of 0 through 14 (P = 0.02). Trends toward a benefit were seen in other groups.In a multivariable ordinal logistic-regression model controlling for age, sex, race, the number of basic and instrumental activities of daily living the patient was able to perform independently two weeks before admission, and each of five characteristics measured on admission (overall health status and APACHE II score, Charlson comorbidity score, mental-status score, and depression score), we found that an increase in the number of activities of daily living performed independently from admission to discharge was independently associated (P =0.04) with assignment to the intervention program. A parallel analysis limited to the 382 patients who provided complete data on their functional status both at admission and at discharge had similar results (data not shown).
With regard to changes from admission to discharge in the ability to perform individual activities of daily living, more patients assigned to the intervention group improved, and fewer became worse, in their ability to bathe and dress themselves (P = 0.006 and P = 0.02, respectively). More patients in the intervention group than in the usual-care group showed improvement in their ability to move from a bed to a chair and to use the toilet, but these differences were not significant (P = 0.2 and P = 0.3, respectively).
Fewer patients assigned to the intervention group were discharged to a long-term care institution (43 patients [14 percent], as compared with 67 patients [22 percent] in the usual-care group; P = 0.01) (Table 4Table 4
Other Outcomes for the 603 Patients Who Survived to Hospital Discharge.). Among the 555 patients admitted to the hospital from private homes who survived to discharge, fewer patients assigned to the intervention group than to the usual-care group were discharged to long-term care institutions for the first time (9 percent vs. 16 percent, P = 0.02). Among the 493 patients discharged to private homes, similar proportions of the intervention and usual-care groups were discharged with plans for new paid health care at home, such as the services of a nurse, homemaker, or health aide (43 percent vs. 41 percent, P = 0.6).Overall health status at discharge was better (P<0.001) for patients assigned to the intervention group (Table 4); this difference remained significant after we controlled for overall health status at admission in a stratified analysis (P = 0.01). In the intervention group, there was a trend toward greater improvement during hospitalization in the patients' ability to perform instrumental activities of daily living (P =0.06) and in their ability to walk (P = 0.10) (Table 4). The patients in the intervention group had a lower mean depression score at discharge than those in the usual-care group (Table 4). The two groups did not differ significantly, however, after we controlled for depression scores on admission in a multivariable linear regression analysis (P = 0.3). Mental status at discharge was similar in the two groups (Table 4).
Resources Used in the Hospital
The mean length of the hospital stay was 1 day shorter for patients assigned to the intervention group (7.3, as compared with 8.3 days for the usual-care group), but the median length of stay was the same (6 days) for each group (P = 0.4). Mean total hospital charges were $10,289 for patients in the intervention group, as compared with $12,412 for patients who received usual care; the median hospital charges were $7,057 and $7,839, respectively (P =0.3; 95 percent confidence interval for the difference between groups, -$1,212 to $392). The cost of additional hours worked by clinical personnel for the 17-month intervention period totaled $65,000. Capital costs allocated to the intervention group for the special features of the unit totaled $10,500. The total costs not reflected in hospital charges were thus approximately $75,500, or $231 for each of the 327 patients assigned to the intervention program.
Outcomes and Use of Resources during the Three Months after Discharge
During the three months after discharge, 82 patients died — 42 (14 percent) assigned to the intervention group and 40 (13 percent) assigned to the usual-care group; 6 patients (1 percent) were lost to follow-up. Three months after discharge, the intervention and usual-care groups did not differ significantly in the mean number of basic activities of daily living the patients could perform independently (4.0 and 3.8, respectively; P = 0.3), the mean number of instrumental activities of daily living they could perform independently (3.9 and 3.8, respectively; P = 0.5), or overall health status as reported by the patients or proxy respondents (P = 0.5).
Among the 493 patients discharged to private homes, similar proportions of the intervention and usual-care groups were admitted to long-term care institutions during the three months after discharge (24 of 260 patients [9 percent] vs. 23 of 233 patients [10 percent], respectively). Fewer patients assigned to the intervention group lived in long-term care institutions at any time during the three months after discharge (67 patients, vs. 90 patients in the usual-care group; P =0.03) (Table 4). Among the 603 patients who survived to discharge, similar numbers in the intervention and usual-care groups were readmitted to acute care hospitals during the three months after discharge (104 of 303 patients [34 percent] vs. 109 of 300 patients [36 percent], respectively; P = 0.6), and similar numbers received paid health care services from nurses, health aides, or homemakers (158 of 303 patients [52 percent] vs. 143 of 300 patients [48 percent]; P = 0.3).
Discussion
This randomized trial provides evidence that specific changes in the provision of acute hospital care can improve the ability of a heterogeneous group of older patients hospitalized with acute illnesses to perform basic activities of daily living at the time of discharge. More patients assigned to the intervention group — as opposed to those who received usual care — improved from admission to discharge in their ability to perform basic activities of daily living, and fewer became worse, despite their somewhat shorter hospital stays and shorter time for recovery before discharge. Other differences observed at discharge were consistent with this main finding, and the differences between the groups remained significant in multivariable and stratified analyses in which we controlled for potentially confounding base-line characteristics of the patients. Fewer patients assigned to the intervention group were discharged to long-term care institutions or lived in them during the three months after discharge. For every 15 patients treated in the intervention unit, 1 more patient was returned home than from the usual-care units, and 1 less patient was admitted to a long-term care institution. The beneficial effects we observed were apparently achieved without increasing in-hospital or post-discharge costs. Nevertheless, it is important to emphasize that the functional status of the majority of patients in both groups was unchanged or worse at the time of discharge. Three months after discharge, the groups did not differ significantly in terms of their ability to perform basic or instrumental activities of daily living.
Comparison with Past Studies
Despite the dramatic benefits of geriatric evaluation and management at the end of acute care hospital stays for at least some patients,34,35 consultative and unit-based interventions to improve the functional outcomes of acutely ill hospitalized older persons have had little benefit.15,17-21,36-43 The intervention we studied differed from most earlier interventions in several ways, notably by incorporating the physical redesign of the hospital unit, the key role assigned to nurses in initiating assessment and case management, and the scheduling of daily rounds by a multidisciplinary team. Two earlier studies44,45 also involved nurse-initiated interventions; both of these studies found evidence of beneficial effects.
Methodologic Considerations
We recognize potential limits to the validity of our findings. The impracticality of blinding patients and interviewers to the treatment assignments may have biased the reports of outcomes. To obtain reports about health status for all patients, proxy reports were required in many cases, and reports from patients and proxies may differ.27,46 Nonetheless, several factors support the validity of our findings. Different outcome measures consistently indicated that the intervention had a beneficial effect. The better function in the intervention group than in the usual-care group at the time of discharge was consistent in subgroup and multivariable analyses. Finally, bias in the design and conduct of the study was reduced by the random assignment of patients, the use of measures with established validity and reliability, and the complete follow-up data for the main outcome variable.
Our study was designed to test the efficacy of the Acute Care for Elders program as a whole, rather than to determine the relative efficacy of its different components, its cost effectiveness, or its long-term effects. Further evaluation will be necessary to address these issues and to test the effectiveness of this approach in other settings.
Implications
The loss of functional independence is not an inevitable consequence of acute illness and hospitalization among older patients. The intervention we studied can serve as a model for improving aspects of overall function — indicated by the ability to care for oneself — that are not specifically related to a particular disease or treatment. Although functional outcomes are rarely the focus of conventional medical care, they may be critical determinants of the quality of life, independence, cost of care, and prognosis among older patients.46-48 Functional outcomes are especially important in acutely ill, hospitalized older patients, who are often frail, chronically ill, and at high risk for functional decline and institutionalization for long-term care.12,14,48 Furthermore, an intervention program such as ours does not preclude, and may complement, disease-specific or treatment-specific efforts to improve patients' outcomes.4-8,49
Presented in part at the annual meetings of the American Federation for Clinical Research, Baltimore, May 1–4, 1992, and Washington, D.C., April 30–May 1, 1993.
Supported by grants from the John A. Hartford Foundation (88277-3G) and the National Institute on Aging (AG-10418-03) to the Claude D. Pepper Older Americans Independence Center at Case Western Reserve University. Dr. Landefeld's work was supported in part by a Career Development Award from the Health Services Research and Development Service, Department of Veterans Affairs, and a George Morris Piersol Teaching and Research Scholarship of the American College of Physicians.
We are indebted to Michael Vender, M.S.S.A., L.I.S.W., the geriatric resource nurses, the staff of the Unit for the Acute Care of Elders, and Barbara Juknialis, M.A., Linda Quinn, M.S., and Miriam Rosenblatt, B.S., for their assistance; we are also indebted to Mary-Margaret Chren, M.D., Sidney Katz, M.D., Donna Regenstreif, Ph.D., David B. Reuben, M.D., Gary E. Rosenthal, M.D., and Mark Sager, M.D., for their comments and suggestions.
Source Information
From the Division of General Internal Medicine and Health Care Research (C.S.L., R.H.F.) and the Division of Geriatrics (C.S.L., R.M.P., R.H.F., J.K.), Department of Medicine, Case Western Reserve University; the University Hospitals of Cleveland (C.S.L., R.M.P., D.M.K., R.H.F., J.K.); and the Cleveland Veterans Affairs Medical Center (C.S.L., J.K.) — all in Cleveland.
Address reprint requests to Dr. Landefeld at the Division of General Internal Medicine and Health Care Research, 111 G(W), Cleveland Veterans Affairs Medical Center, 10701 E. Blvd., Cleveland, OH 44106.
- References
References
1
Epstein AM . The outcomes movement -- will it get us where we want to go? N Engl J Med 1990;323:266-269
Full Text | Web of Science | Medline2
Relman AS . Assessment and accountability: the third revolution in medical care. N Engl J Med 1988;319:1220-1222
Full Text | Web of Science | Medline3
Kritchevsky SB ,Simmons BP . Continuous quality improvement: concepts and applications for physician care. JAMA 1991;266:1817-1823
CrossRef | Web of Science | Medline4
Weingarten SR ,Riedinger MS ,Shinbane J , et al. Triage practice guideline for patients hospitalized with congestive heart failure: improving the effectiveness of the coronary care unit. Am J Med 1993;94:483-490
CrossRef | Web of Science | Medline5
Weingarten SR ,Riedinger MS ,Conner L , et al. Practice guidelines and reminders to reduce duration of hospital stay for patients with chest pain: an interventional trial. Ann Intern Med 1994;120:257-263
Web of Science | Medline6
Landefeld CS ,Anderson PA . Guideline-based consultation to prevent anticoagulant-related bleeding: a randomized, controlled trial in a teaching hospital. Ann Intern Med 1992;116:829-837
Web of Science | Medline7
Hannan EL ,Kilburn H Jr ,Racz M ,Shields E ,Chassin MR . Improving the outcomes of coronary artery bypass surgery in New York state. JAMA 1994;271:761-766
CrossRef | Web of Science | Medline8
Lomas J ,Enkin M ,Anderson GM ,Hannah WJ ,Vayda E ,Singer J . Opinion leaders vs audit and feedback to implement practice guidelines: delivery after previous cesarean section. JAMA 1991;265:2202-2207
CrossRef | Web of Science | Medline9
Greco PJ ,Eisenberg JM . Changing physicians' practices. N Engl J Med 1993;329:1271-1274
Full Text | Web of Science | Medline10
Litzelman DK ,Dittus RS ,Miller ME ,Tierney WM . Requiring physicians to respond to computerized reminders improves their compliance with preventive care protocols. J Gen Intern Med 1993;8:311-317
CrossRef | Web of Science | Medline11
Hahn B, Lefkowitz D. Annual expenses and sources of payment for health care services: national medical expenditure survey: research findings 14. Rockville, Md.: Agency for Health Care Policy and Research, Public Health Service, 1992. (DHHS publication no. (AHCPR) 93-0007.)
12
Creditor MC . Hazards of hospitalization of the elderly. Ann Intern Med 1993;118:219-223
Web of Science | Medline13
Gillick MR ,Serrell NA ,Gillick LS . Adverse consequences of hospitalization in the elderly. Soc Sci Med 1982;16:1033-1038
CrossRef | Web of Science | Medline14
Hirsch CH ,Sommers L ,Olsen A ,Mullen L ,Winograd CH . The natural history of functional morbidity in hospitalized older patients. J Am Geriatr Soc 1990;38:1296-1303
Web of Science | Medline15
McVey LJ ,Becker PM ,Saltz CC ,Feussner JR ,Cohen HJ . Effect of a geriatric consultation team on functional status of elderly hospitalized patients: a randomized, controlled clinical trial. Ann Intern Med 1989;110:79-84
Web of Science | Medline16
Winograd CH ,Gerety MB ,Chung M ,Goldstein MK ,Dominguez F Jr ,Vallone R . Screening for frailty: criteria and predictors of outcomes. J Am Geriatr Soc 1991;39:778-784
Web of Science | Medline17
Winograd CH ,Gerety MB ,Lai NA . A negative trial of inpatient geriatric consultation: lessons learned and recommendations for future research. Arch Intern Med 1993;153:2017-2023
CrossRef | Web of Science | Medline18
Fretwell MD ,Raymond PM ,McGarvey ST , et al. The Senior Care Study: a controlled trial of a consultative/unit-based geriatric assessment program in acute care. J Am Geriatr Soc 1990;38:1073-1081
Web of Science | Medline19
Hogan DB ,Fox RA ,Badley BWD ,Mann OE . Effect of a geriatric consultation service on management of patients in an acute care hospital. Can Med Assoc J 1987;136:713-717
Web of Science20
Hogan DB ,Fox RA . A prospective controlled trial of a geriatric consultation team in an acute-care hospital. Age Ageing 1990;19:107-113
CrossRef | Web of Science | Medline21
Thomas DR ,Brahan R ,Haywood BP . Inpatient community-based geriatric assessment reduces subsequent mortality. J Am Geriatr Soc 1993;41:101-104
Web of Science | Medline22
Palmer RM ,Landefeld CS ,Kresevic D ,Kowal J . A medical unit for the acute care of the elderly. J Am Geriatr Soc 1994;42:545-552
Web of Science | Medline23
Katz S ,Ford AB ,Moskowitz RW ,Jackson BA ,Jaffe MW . Studies of illness in the aged: the Index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185:914-919
Web of Science | Medline24
Lawton MP ,Brody EM . Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179-186
CrossRef | Web of Science | Medline25
Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In: Brink TL, ed. Clinical gerontology: a guide to assessment and intervention. New York: Haworth Press, 1986:165-73.
26
Folstein MF ,Folstein SE ,McHugh PR . “Mini-Mental State“: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198
CrossRef | Web of Science | Medline27
Weinberger M ,Samsa GP ,Schmader K ,Greenberg SM ,Carr DB ,Wildman DS . Comparing proxy and patients' perceptions of patients' functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc 1992;40:585-588
Web of Science | Medline28
Charlson ME ,Sax FL ,MacKenzie R ,Fields SD ,Braham RL ,Douglas RG Jr . Resuscitation: how do we decide? A prospective study of physicians' preferences and the clinical course of hospitalized patients. JAMA 1986;255:1316-1322
CrossRef | Web of Science | Medline29
Charlson ME ,Pompei P ,Ales KL ,MacKenzie CR . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-383
CrossRef | Medline30
Knaus WA ,Draper EA ,Wagner DP ,Zimmerman JE . APACHE II: a severity of disease classification system. Crit Care Med 1985;13:818-829
CrossRef | Web of Science | Medline31
Box GEP, Hunter WG, Hunter JS. Statistics for experimenters: an introduction to design, data analysis, and model building. New York: John Wiley, 1978.
32
Bross IDJ . How to use ridit analysis. Biometrics 1958;14:18-38
CrossRef | Web of Science33
Neter J, Wasserman W, Kutner MH. Applied linear regression models. Homewood, Ill.: R.D. Irwin, 1983.
34
Rubenstein LZ ,Josephson KR ,Wieland GD ,English PA ,Sayre JA ,Kane RL . Effectiveness of a geriatric evaluation unit: a randomized clinical trial. N Engl J Med 1984;311:1664-1670
Full Text | Web of Science | Medline35
Applegate WB ,Miller ST ,Graney MJ ,Elam JT ,Burns R ,Akins DE . A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. N Engl J Med 1990;322:1572-1578
Full Text | Web of Science | Medline36
Allen CM ,Becker PM ,McVey LJ ,Saltz C ,Feussner JR ,Cohen HJ . A randomized, controlled clinical trial of a geriatric consultation team: compliance with recommendations. JAMA 1986;255:2617-2621
CrossRef | Web of Science | Medline37
Saltz CC ,McVey LJ ,Becker PM ,Feussner JR ,Cohen HJ . Impact of a geriatric consultation team on discharge placement and repeat hospitalization. Gerontologist 1988;28:344-350
CrossRef | Web of Science | Medline38
Teasdale TA ,Shuman L ,Snow E ,Luchi RJ . A comparison of placement outcomes of geriatric cohorts receiving care in a geriatric assessment unit and on general medicine floors. J Am Geriatr Soc 1983;31:529-534
Web of Science | Medline39
Popplewell PY ,Henschke PJ . What is the value of a geriatric assessment unit in a teaching hospital? A comparative study of the management of elderly inpatients. Aust Health Rev 1983;6:23-25
Medline40
Collard AF ,Bachman SS ,Beatrice DF . Acute care delivery for the geriatric patient: an innovative approach. Qual Rev Bull 1985;11:180-185
Medline41
Harris RD ,Henschke PJ ,Popplewell PY , et al. A randomised study of outcomes in a defined group of acutely ill elderly patients managed in a geriatric assessment unit or a general medical unit. Aust N Z J Med 1991;21:230-234
CrossRef | Medline42
Gilchrist WJ ,Newman RJ ,Hamblen DL ,Williams BO . Prospective randomised study of an orthopaedic geriatric inpatient service. BMJ 1988;297:1116-1118
CrossRef | Web of Science | Medline43
Meissner P ,Andolsek K ,Mears PA ,Fletcher B . Maximizing the functional status of geriatric patients in an acute community hospital setting. Gerontologist 1989;29:524-528
CrossRef | Web of Science | Medline44
Inouye SK ,Wagner DR ,Acampora D ,Horwitz RI ,Cooney LM ,Tinetti ME . A controlled trial of a nursing-centered intervention in hospitalized elderly medical patients: the Yale Geriatric Care Program. J Am Geriatr Soc 1993;41:1353-1360
Web of Science | Medline45
Boyer N ,Chuang JL ,Gipner D . An acute care geriatric unit. Nurs Manage 1986;17:22-25
Medline46
Rubenstein LZ ,Schairer C ,Wieland GD ,Kane R . Systematic biases in functional status assessment of elderly adults: effects of different data sources. J Gerontol 1984;39:686-691
Medline47
Guralnik JM ,LaCroix AZ ,Branch LG ,Kasl SD ,Wallace RD . Morbidity and disability in older persons in the years prior to death. Am J Public Health 1991;81:443-447
CrossRef | Web of Science | Medline48
Katz S ,Branch LG ,Branson MH ,Papsidero JA ,Beck JC ,Greer DS . Active life expectancy. N Engl J Med 1983;309:1218-1224
Full Text | Web of Science | Medline49
Audet A-M ,Greenfield S ,Field M . Medical practice guidelines: current activities and future directions. Ann Intern Med 1990;113:709-714
Web of Science | Medline
- Citing Articles (203)
Citing Articles
1
Malaz A. Boustani, Noll L. Campbell, Babar A. Khan, Greg Abernathy, Mohammed Zawahiri, Tiffany Campbell, Jason Tricker, Siu L. Hui, John D. Buckley, Anthony J. Perkins, Mark O. Farber, Christopher M. Callahan. (2012) Enhancing Care for Hospitalized Older Adults with Cognitive Impairment: A Randomized Controlled Trial. Journal of General Internal Medicine
CrossRef2
C. Friedrich, I. Adamietz, L. Pientka. (2012) Geriatrisches Assessment. Der Onkologe 18:2, 163-172
CrossRef3
Sinead A. Coleman, Conal J. Cunningham, James Bernard Walsh, Davis Coakley, Joe Harbison, Miriam Casey, Niamh Murphy, N. Frances Horgan. (2011) Outcomes among older people in a post-acute inpatient rehabilitation unit. Disability and Rehabilitation1-6
CrossRef4
M. Di Bari, F. Salvi, A. T. Roberts, D. Balzi, B. Lorenzetti, V. Morichi, L. Rossi, F. Lattanzio, N. Marchionni. (2011) Prognostic Stratification of Elderly Patients in the Emergency Department: A Comparison Between the "Identification of Seniors at Risk" and the "Silver Code". The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
CrossRef5
Renata Linertová, Lidia García-Pérez, José Ramón Vázquez-Díaz, Antonio Lorenzo-Riera, Antonio Sarría-Santamera. (2011) Interventions to reduce hospital readmissions in the elderly: in-hospital or home care. A systematic review. Journal of Evaluation in Clinical Practice 17:6, 1167-1175
CrossRef6
T. M. Gill, E. A. Gahbauer, L. Han, H. G. Allore. (2011) The Relationship Between Intervening Hospitalizations and Transitions Between Frailty States. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 66A:11, 1238-1243
CrossRef7
Joseph H. Flaherty, Milta O. Little. (2011) Matching the Environment to Patients with Delirium: Lessons Learned from the Delirium Room, a Restraint-Free Environment for Older Hospitalized Adults with Delirium. Journal of the American Geriatrics Society 59, S295-S300
CrossRef8
, C. Lafont, S. Gérard, T. Voisin, M. Pahor, B. Vellas. (2011) Comment réduire la dépendance iatrogène chez les sujets âgés hospitalisés ?. Les cahiers de l'année gérontologique 3:S1, 6-26
CrossRef9
Jerome W. Yates, Mya Thein, William B. Ershler. (2011) Opinion on opinions about geriatric assessment. Archives of Gerontology and Geriatrics
CrossRef10
I. Ekman, A. Wolf, L.-E. Olsson, C. Taft, K. Dudas, M. Schaufelberger, K. Swedberg. (2011) Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. European Heart Journal
CrossRef11
J. George, J. Adamson, H. Woodford. (2011) Joint geriatric and psychiatric wards: a review of the literature. Age and Ageing 40:5, 543-548
CrossRef12
Shanmugam Uthamalingam, Gagandeep S. Gurm, Marilyn Daley, James Flynn, Robert Capodilupo. (2011) Usefulness of Acute Delirium as a Predictor of Adverse Outcomes in Patients >65 Years of Age With Acute Decompensated Heart Failure. The American Journal of Cardiology 108:3, 402-408
CrossRef13
Graham Ellis, Martin A Whitehead, Desmond O'Neill, Peter Langhorne, David Robinson, Graham Ellis. 2011. Comprehensive geriatric assessment for older adults admitted to hospital. .
CrossRef14
Mario Ulises Pérez-Zepeda, Luis Miguel Gutiérez-Robledo, Sergio Sánchez-Garcia, Teresa Juárez-Cedillo, Jose Juan García Gonzalez, Francisco Franco-Marina, Carmen García-Peña. (2011) Comparison of a geriatric unit with a general ward in Mexican elders. Archives of Gerontology and Geriatrics
CrossRef15
Angelena Maria Labella, Susan Eva Merel, Elizabeth Anne Phelan. (2011) Ten ways to improve the care of elderly patients in the hospital. Journal of Hospital Medicine 6:6, 351-357
CrossRef16
Pedro Abizanda, Matilde León, Laura Domínguez-Martín, Vicente Lozano-Berrio, Luis Romero, Carmen Luengo, Pedro M. Sánchez-Jurado, Elena Martín-Sebastiá. (2011) Effects of a short-term occupational therapy intervention in an acute geriatric unit. A randomized clinical trial. Maturitas 69:3, 273-278
CrossRef17
Jeffrey I. Farber, Beartriz Korc-Grodzicki, Qingling Du, Rosanne M. Leipzig, Albert L. Siu. (2011) Operational and quality outcomes of a mobile acute care for the elderly service. Journal of Hospital Medicine 6:6, 358-363
CrossRef18
C. R. Carpenter, M. N. Shah, F. M. Hustey, K. Heard, L. W. Gerson, D. K. Miller. (2011) High Yield Research Opportunities in Geriatric Emergency Medicine: Prehospital Care, Delirium, Adverse Drug Events, and Falls. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 66A:7, 775-783
CrossRef19
Kala M. Mehta, Edgar Pierluissi, W. John Boscardin, Katharine A. Kirby, Louise C. Walter, Mary-Margaret Chren, Robert M. Palmer, Steven R. Counsell, C. Seth Landefeld. (2011) A Clinical Index to Stratify Hospitalized Older Adults According to Risk for New-Onset Disability. Journal of the American Geriatrics Society 59:7, 1206-1216
CrossRef20
Juan J. Baztán, Francisco M. Suárez-García, Jesús López-Arrieta, Leocadio Rodríguez-Mañas. (2011) Eficiencia de las unidades geriátricas de agudos: metaanálisis de estudios controlados. Revista Española de Geriatría y Gerontología 46:4, 186-192
CrossRef21
Heidi L. Wald, Jeffrey J. Glasheen, Jeannette Guerrasio, Jean M. Youngwerth, Ethan Ulysses Cumbler. (2011) Evaluation of a hospitalist-run acute care for the elderly service. Journal of Hospital Medicine 6:6, 313-321
CrossRef22
J Spencer, H Cooper. (2011) A multidisciplinary paediatric diabetes health care team: perspectives on adolescent care. Practical Diabetes International 28:5, 212-215
CrossRef23
Bianca M. Buurman, Barbara C. van Munster, Johanna C. Korevaar, Rob J. de Haan, Sophia E. de Rooij. (2011) Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review. Journal of Clinical Epidemiology 64:6, 619-627
CrossRef24
Ming-Hsien Lin, Chien-Liang Liu, Li-Ning Peng, Yi-Tsun Chen, Liang-Kung Chen. (2011) Demographic characteristics and clinical benefits of outpatient geriatric evaluation and management service in Taiwan. Archives of Gerontology and Geriatrics
CrossRef25
G. Pope, N. Wall, C. M. Peters, M. O'Connor, J. Saunders, C. O'Sullivan, T. M. Donnelly, T. Walsh, S. Jackson, D. Lyons, D. Clinch. (2011) Specialist medication review does not benefit short-term outcomes and net costs in continuing-care patients. Age and Ageing 40:3, 307-312
CrossRef26
Louise D Hickman, Patricia M Davidson, Esther Chang, Lynn Chenoweth. (2011) INHospital Study: Do older people, carers and nurses share the same priorities of care in the acute aged care setting?. International Journal of Multiple Research Approaches 5:1, 76-88
CrossRef27
Lorenzo Palleschi, Walter De Alfieri, Bernardo Salani, Filippo Luca Fimognari, Alberto Marsilii, Andrea Pierantozzi, Luigi Di Cioccio, Stefano Maria Zuccaro. (2011) Functional Recovery of Elderly Patients Hospitalized in Geriatric and General Medicine Units. The PROgetto DImissioni in GEriatria Study. Journal of the American Geriatrics Society 59:2, 193-199
CrossRef28
Yên-Lan Nguyen, Derek C Angus, Ariane Boumendil, Bertrand Guidet. (2011) The challenge of admitting the very elderly to intensive care. Annals of Intensive Care 1:1, 29
CrossRef29
Hannah Wunsch, Hayley Gershengorn, Stephan A Mayer, Jan Claassen. (2011) The effect of window rooms on critically ill patients with subarachnoid hemorrhage admitted to intensive care. Critical Care 15:2, R81
CrossRef30
J. H. Flaherty, D. K. Steele, J. T. Chibnall, V. N. Vasudevan, N. Bassil, S. Vegi. (2010) An ACE Unit With a Delirium Room May Improve Function and Equalize Length of Stay Among Older Delirious Medical Inpatients. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 65A:12, 1387-1392
CrossRef31
Annette L. Adams, Melissa A. Schiff, Thomas D. Koepsell, Frederick P. Rivara, Brian G. Leroux, Thomas M. Becker, Jerris R. Hedges. (2010) Physician Consultation, Multidisciplinary Care, and 1-Year Mortality in Medicare Recipients Hospitalized with Hip and Lower Extremity Injuries. Journal of the American Geriatrics Society 58:10, 1835-1842
CrossRef32
Robert M. Palmer. (2010) Quality of Care in Hospital and Postdischarge Mortality. Journal of the American Geriatrics Society 58:9, 1801-1802
CrossRef33
Susan E. Merel, Wayne McCormick. (2010) Geriatricians and Hospitalists: Opportunities for Partnership. Journal of the American Geriatrics Society 58:9, 1803-1805
CrossRef34
Nasiya N. Ahmed, Shannon E. Pearce. (2010) Acute Care for the Elderly: A Literature Review. Population Health Management 13:4, 219-225
CrossRef35
Marie Boltz, Elizabeth Capezuti, Nina Shabbat, Kimberly Hall. (2010) Going home better not worse: Older adults' views on physical function during hospitalization. International Journal of Nursing Practice 16:4, 381-388
CrossRef36
A. M. Mudge, P. O'Rourke, C. P. Denaro. (2010) Timing and Risk Factors for Functional Changes Associated With Medical Hospitalization in Older Patients. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 65A:8, 866-872
CrossRef37
Dominique Somme, Nathalie Andrieux, Emmanuel Guérot, Hayat Lahjibi-Paulet, Céline Lazarovici, Mathilde Gisselbrecht, Jean-Yves Fagon, Olivier Saint-Jean. (2010) Loss of autonomy among elderly patients after a stay in a medical intensive care unit (ICU): A randomized study of the benefit of transfer to a geriatric ward. Archives of Gerontology and Geriatrics 50:3, e36-e40
CrossRef38
Athanasios Douzenis, Ioannis Michopoulos, Rossetos Gournellis, Christos Christodoulou, Christina Kalkavoura, Panayiota G. Michalopoulou, Katerina Fineti, Paulos Patapis, Konstantinos Protopapas, Lefteris Lykouras. (2010) Cognitive decline and dementia in elderly medical inpatients remain underestimated and underdiagnosed in a recently established university general hospital in Greece. Archives of Gerontology and Geriatrics 50:2, 147-150
CrossRef39
(2010) Australian and New Zealand Society for Geriatric Medicine�Position Statement - Geriatric Services in General Hospitals. Australasian Journal on Ageing 29:1, 43-46
CrossRef40
M. D. Bari, D. Balzi, A. T. Roberts, A. Barchielli, S. Fumagalli, A. Ungar, S. Bandinelli, W. De Alfieri, L. Gabbani, N. Marchionni. (2010) Prognostic Stratification of Older Persons Based on Simple Administrative Data: Development and Validation of the "Silver Code," To Be Used in Emergency Department Triage. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 65A:2, 159-164
CrossRef41
Hao-Hsiang Chang, Shih-Li Tsai, Ching-Yu Chen, Wen-Jing Liu. (2010) Outcomes of hospitalized elderly patients with geriatric syndrome: report of a community hospital reform plan in Taiwan. Archives of Gerontology and Geriatrics 50, S30-S33
CrossRef42
Tania Zieschang, Ilona Dutzi, Elke Müller, Ute Hestermann, Katinka Grünendahl, Anke Karin Braun, Daniel Hüger, Daniel Kopf, Norbert Specht-Leible, Peter Oster. (2010) Improving care for patients with dementia hospitalized for acute somatic illness in a specialized care unit: a feasibility study. International Psychogeriatrics 22:01, 139
CrossRef43
Sasha Shepperd, Jacqueline McClaran, Christopher O Phillips, Natasha A Lannin, Lindy M Clemson, Annie McCluskey, Ian D Cameron, Sarah L Barras, Sasha Shepperd. 2010. Discharge planning from hospital to home. .
CrossRef44
Timothy H. M. To, Owen J. Davies, Jackie Sincock, Craig Whitehead. (2010) Multidisciplinary care needs in an Australian tertiary teaching hospital. Australian Health Review 34:2, 234
CrossRef45
Marie Boltz, Elizabeth Capezuti, Nina Shabbat. (2010) Building a framework for a geriatric acute care model. Leadership in Health Services 23:4, 334-360
CrossRef46
Chad Boult, Ariel Frank Green, Lisa B. Boult, James T. Pacala, Claire Snyder, Bruce Leff. (2009) Successful Models of Comprehensive Care for Older Adults with Chronic Conditions: Evidence for the Institute of Medicine's âRetooling for an Aging Americaâ Report. Journal of the American Geriatrics Society 57:12, 2328-2337
CrossRef47
Youcef Sennour, Steven R. Counsell, Jerrlyn Jones, Michael Weiner. (2009) Development and Implementation of a Proactive Geriatrics Consultation Model in Collaboration with Hospitalists. Journal of the American Geriatrics Society 57:11, 2139-2145
CrossRef48
Renzo Rozzini, Intissar Sleiman, Stefania Maggi, Marianna Noale, Marco Trabucchi. (2009) Gender Differences and Health Status in Old and Very Old Patients. Journal of the American Medical Directors Association 10:8, 554-558
CrossRef49
Cynthia J. Brown, David T. Redden, Kellie L. Flood, Richard M. Allman. (2009) The Underrecognized Epidemic of Low Mobility During Hospitalization of Older Adults. Journal of the American Geriatrics Society 57:9, 1660-1665
CrossRef50
Louise Gordge, Jenny De Young, Rick Wiechula. (2009) Reducing functional decline of older people in an acute-care setting: are we providing adequate care to maintain/optimise the functional status of our elder patients?. International Journal of Evidence-Based Healthcare 7:3, 181-186
CrossRef51
Luis Romero Rizos, Pedro Manuel Sánchez Jurado, Pedro Abizanda Soler. (2009) El anciano en la unidad de geriatría de agudos. Revista Española de Geriatría y Gerontología 44, 15-26
CrossRef52
I. Sleiman, R. Rozzini, P. Barbisoni, A. Morandi, A. Ricci, A. Giordano, M. Trabucchi. (2009) Functional Trajectories During Hospitalization: A Prognostic Sign for Elderly Patients. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 64A:6, 659-663
CrossRef53
Bruce Leff, Lynda Burton, Scott L. Mader, Bruce Naughton, Jeffrey Burl, William B. Greenough, Susan Guido, Donald Steinwachs. (2009) Comparison of Functional Outcomes Associated with Hospital at Home Care and Traditional Acute Hospital Care. Journal of the American Geriatrics Society 57:2, 273-278
CrossRef54
Douglas Paddon-Jones, Blake B Rasmussen. (2009) Dietary protein recommendations and the prevention of sarcopenia. Current Opinion in Clinical Nutrition and Metabolic Care 12:1, 86-90
CrossRef55
Patrick Kortebein. (2009) Rehabilitation for Hospital-Associated Deconditioning. American Journal of Physical Medicine & Rehabilitation 88:1, 66-77
CrossRef56
SN Hilmer, D Gnjidic. (2009) The Effects of Polypharmacy in Older Adults. Clinical Pharmacology & Therapeutics 85:1, 86-88
CrossRef57
Scott L. Mader, Marijo C. Medcraft, Carol Joseph, Kay L. Jenkins, Nancy Benton, Kathleen Chapman, Maggie A. Donius, Carol Baird, Richard Harper, Yasmin Ansari, Jim A. Jackson, William Schutzer. (2008) Program at Home: A Veterans Affairs Healthcare Program to Deliver Hospital Care in the Home. Journal of the American Geriatrics Society 56:12, 2317-2322
CrossRef58
Ewa Wressle, Lennart Eriksson, Amie Fahlander, Helena Håkansson, Anna-Lena Jönsson, Britt-Marie Martinsson, Ing-Marie Rasmusson, Ingrid Sjölander, Karin Tängmark. (2008) Relatives’ perspective on the quality of geriatric care and rehabilitation - development and testing of a questionnaire. Scandinavian Journal of Caring Sciences 22:4, 590-595
CrossRef59
Min-Hsueh Weng. (2008) The effect of protective treatment in reducing pressure ulcers for non-invasive ventilation patients. Intensive and Critical Care Nursing 24:5, 295-299
CrossRef60
W. Raffaeli, G. Varrassi, D. Righetti, M.C. Monterubbianesi, J. Andruccioli, D. Sarti, F. Marinangeli, M.L. Ursini, A. Piroli, A. Paladini. (2008) Epidemiology and treatment of pain in Italy: part II. European Journal of Pain Supplements 2:1, 47-51
CrossRef61
Paula M. Podrazik, Stacie Levine, Sandy Smith, Don Scott, Catherine E. DuBeau, Aliza Baron, Chad Whelan, Julie Johnson, Sandy Cook, Vineet Arora, David Meltzer, Greg Sachs. (2008) The Curriculum for the Hospitalized Aging Medical Patient program: A collaborative faculty development program for hospitalists, general internists, and geriatricians. Journal of Hospital Medicine 3:5, 384-393
CrossRef62
S. M. Friedman, D. A. Mendelson, K. W. Bingham, R. M. McCann. (2008) Hazards of Hospitalization: Residence Prior to Admission Predicts Outcomes. The Gerontologist 48:4, 537-541
CrossRef63
J. Gómez Pavón, I. Martín Lesende, J.J. Baztán Cortés, P. Regato Pajares, F. Formiga Pérez, A. Segura Benedito, P. Abizanda Soler, J. de Pedro Cuesta. (2008) Prevención de la dependencia en las personas mayores. Revista Clínica Española 208:7, 361.e1-361.e39
CrossRef64
Chad Boult, Colleen Christmas, Samuel C. Durso, Bruce Leff, Lisa B. Boult, Linda P. Fried. (2008) Perspective: Transforming Chronic Care for Older Persons. Academic Medicine 83:7, 627-631
CrossRef65
C. Blanc-Bisson, A. Dechamps, G. Gouspillou, P. Dehail, I. Bourdel-Marchasson. (2008) A randomized controlled trial on early physiotherapy intervention versus usual care in acute car unit for elderly: Potential benefits in light of dietary intakes. The Journal of Nutrition Health and Aging 12:6, 395-399
CrossRef66
Alison M. Mudge, Andrea J. Giebel, Alison J. Cutler. (2008) Exercising Body and Mind: An Integrated Approach to Functional Independence in Hospitalized Older People. Journal of the American Geriatrics Society 56:4, 630-635
CrossRef67
Paula M. Podrazik, Chad T. Whelan. (2008) Acute Hospital Care for the Elderly Patient: Its Impact on Clinical and Hospital Systems of Care. Medical Clinics of North America 92:2, 387-406
CrossRef68
Cheryl Chia-Hui Chen, Charlotte Wang, Guan-Hua Huang. (2008) Functional Trajectory 6 Months Posthospitalization. Nursing Research 57:2, 93-100
CrossRef69
K HURST. (2008) UK ward design: Patient dependency, nursing workload, staffing and quality—An observational study. International Journal of Nursing Studies 45:3, 370-381
CrossRef70
(2008) Functional Outcomes for Clinical Trials in Frail Older Persons: Time To Be Moving: Working Group on Functional Outcome Measures for Clinical Trials. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 63:2, 160-164
CrossRef71
Gilles Albrand, Catherine Terret. (2008) Early Breast Cancer in the Elderly. Drugs & Aging 25:1, 35-45
CrossRef72
Susan L. Norris, Kevin High, Thomas M. Gill, Sean Hennessy, Jean S. Kutner, David B. Reuben, Jürgen Unützer, C. Seth Landefeld. (2008) Health Care for Older Americans with Multiple Chronic Conditions: A Research Agenda. Journal of the American Geriatrics Society 56:1, 149-159
CrossRef73
F. Salvi, V. Morichi, A. Grilli, R. Giorgi, G. Tommaso, P. Dessì-Fulgheri. (2007) The elderly in the emergency department: a critical review of problems and solutions. Internal and Emergency Medicine 2:4, 292-301
CrossRef74
Takashi Yamanaka, Emiko Takasugi, Norihiro Hotta, Yutaka Kubo, Kuniaki Otsuka. (2007) Daily living functions of the elderly requiring home visits: A study at a comprehensive assessment clinic for the elderly. Geriatrics & Gerontology International 7:4, 388-392
CrossRef75
Javier Gómez Pavón, Iñaki Martín Lesende, Juan José Baztán Cortés, Pilar Regato Pajares, Francesc Formiga Pérez, Andreu Segura Benedito, Pedro Abizanda Soler, Jesús De Pedro Cuesta. (2007) Prevención de la dependencia en las personas mayores. Revista Española de Geriatría y Gerontología 42, 15-56
CrossRef76
Kellie L. Flood, Amy Rohlfing, Cyndi V. Le, David B. Carr, Michael W. Rich. (2007) Geriatric syndromes in elderly patients admitted to an inpatient cardiology ward. Journal of Hospital Medicine 2:6, 394-400
CrossRef77
Ula Hwang, R. Sean Morrison. (2007) The Geriatric Emergency Department. Journal of the American Geriatrics Society 55:11, 1873-1876
CrossRef78
SEIJI HAMA, HIDEHISA YAMASHITA, MASAYA SHIGENOBU, ATSUKO WATANABE, KEIKO HIRAMOTO, YASUO TAKIMOTO, RYOZO ARAKAWA, KAORU KURISU, SHIGETO YAMAWAKI, TAMOTSU KITAOKA. (2007) Sitting balance as an early predictor of functional improvement in association with depressive symptoms in stroke patients. Psychiatry and Clinical Neurosciences 61:5, 543-551
CrossRef79
Louise Hickman, Phillip Newton, Elizabeth J. Halcomb, Esther Chang, Patricia Davidson. (2007) Best practice interventions to improve the management of older people in acute care settings: a literature review. Journal of Advanced Nursing 60:2, 113-126
CrossRef80
C. M. Boyd, C. Boult, E. Shadmi, B. Leff, R. Brager, L. Dunbar, J. L. Wolff, S. Wegener. (2007) Guided Care for Multimorbid Older Adults: Kathleen Walsh Piercy, PhD, Editor. The Gerontologist 47:5, 697-704
CrossRef81
Pierre-Olivier Lang, Nicolas Meyer, Damien Heitz, Moustapha Dramé, Nicolas Jovenin, Joël Ankri, Dominique Somme, Jean-Luc Novella, Jean-Bernard Gauvain, Pascal Couturier, Isabelle Lanièce, Thierry Voisin, Benoit Wazières, Régis Gonthier, Claude Jeandel, Damien Jolly, Olivier Saint-Jean, François Blanchard. (2007) Loss of independence in Katz’s ADL ability in connection with an acute hospitalization: early clinical markers in French older people. European Journal of Epidemiology 22:9, 621-630
CrossRef82
E CHANG, K HANCOCK, L HICKMAN, J GLASSON, P DAVIDSON. (2007) Outcomes of acutely ill older hospitalized patients following implementation of tailored models of care: A repeated measures (pre- and post-intervention) design. International Journal of Nursing Studies 44:7, 1079-1092
CrossRef83
Sophia Rooij, Marieke Schuurmans, Bianca Buurman, Joke Korevaar. (2007) Acuut opgenomen in het ziekenhuis. Nederlands Tijdschrift voor Evidence Based Practice 5:4, 99-102
CrossRef84
Stephen O’Mahony, Eric Mazur, Pamela Charney, Yun Wang, Jonathan Fine. (2007) Use of Multidisciplinary Rounds to Simultaneously Improve Quality Outcomes, Enhance Resident Education, and Shorten Length of Stay. Journal of General Internal Medicine 22:8, 1073-1079
CrossRef85
Juan I. González-Montalvo, Juan J. Baztán Cortés, Teresa Alarcón Alarcón, Almudena Bárcena Álvarez. (2007) Resultados asistenciales de las unidades geriátricas de agudos. Revisión sistemática. Revista Española de Geriatría y Gerontología 42:4, 240-250
CrossRef86
José Augusto García Navarro. (2007) Unidades de agudos de geriatría: todavía queda camino por recorrer. Revista Española de Geriatría y Gerontología 42:4, 199-200
CrossRef87
M. Anpalahan, S. J. Gibson. (2007) Geriatric syndromes as predictors of adverse outcomes of hospitalization. Internal Medicine Journal 0:0, 070602000936008-???
CrossRef88
Najma Siddiqi, Rachel Holt, Annette M Britton, John Holmes, Najma Siddiqi. 2007. Interventions for preventing delirium in hospitalised patients. .
CrossRef89
Peter D Griffiths, Margaret E Edwards, Angus Forbes, Ruth G Harris, Gill Ritchie, Peter D Griffiths. 2007. Effectiveness of intermediate care in nursing-led in-patient units. .
CrossRef90
Thomas M. Gill, Ling Han, Heather G. Allore. (2007) Predisposing Factors and Precipitants for Bathing Disability in Older Persons. Journal of the American Geriatrics Society 55:4, 534-540
CrossRef91
Laurent Michaud, Christophe Büla, Alexandre Berney, Vincent Camus, Rachel Voellinger, Friedrich Stiefel, Bernard Burnand. (2007) Delirium: Guidelines for general hospitals. Journal of Psychosomatic Research 62:3, 371-383
CrossRef92
Jayna M. Holroyd-Leduc, Saunak Sen, Dan Bertenthal, Laura P. Sands, Robert M. Palmer, Denise M. Kresevic, Kenneth E. Covinsky, C. Seth Landefeld. (2007) The Relationship of Indwelling Urinary Catheters to Death, Length of Hospital Stay, Functional Decline, and Nursing Home Admission in Hospitalized Older Medical Patients. Journal of the American Geriatrics Society 55:2, 227-233
CrossRef93
M. Sonnenblick, D. Raveh, L. Gratch, A. Yinnon. (2007) Clinical and demographic characteristics of elderly patients hospitalised in an internal medicine department in Israel. International Journal of Clinical Practice 61:2, 247-254
CrossRef94
Natalie de Morton, Jennifer L Keating, Kim Jeffs, Natalie de Morton. 2007. Exercise for acutely hospitalised older medical patients. .
CrossRef95
B.J. Fontecha Gómez, T. Casanova i Querol, Ll. Reig Puig, P. Sánchez Ferrín. (2006) Enfermos pluripatológicos y atención geriátrica. Revista Clínica Española 206:10, 534
CrossRef96
Graham Ellis, Martin A Whitehead, David Robinson, Desmond O'Neill, Peter Langhorne, Graham Ellis. 2006. Comprehensive geriatric assessment for older adults admitted to hospital. .
CrossRef97
A. Mudge, S. Laracy, K. Richter, C. Denaro. (2006) Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care. Internal Medicine Journal 36:9, 558-563
CrossRef98
Anette Hylen Ranhoff, Renzo Rozzini, Tony Sabatini, Angela Cassinadri, Stefano Boffelli, Marco Ferri, Nicola Travaglini, Antonella Ricci, Alessandro Morandi, Marco Trabucchi. (2006) Subintensive care unit for the elderly: a new model of care for critically ill frail elderly medical patients. Internal and Emergency Medicine 1:3, 197-203
CrossRef99
Steven R. Counsell, Christopher M. Callahan, Amna B. Buttar, Daniel O. Clark, Kathryn I. Frank. (2006) Geriatric Resources for Assessment and Care of Elders (GRACE): A New Model of Primary Care for Low-Income Seniors. Journal of the American Geriatrics Society 54:7, 1136-1141
CrossRef100
Ravishankar Jayadevappa, Sumedha Chhatre, Mark Weiner, Donna B. Raziano. (2006) Health Resource Utilization and Medical Care Cost of Acute Care Elderly Unit Patients. Value in Health 9:3, 186-192
CrossRef101
(2006) Interdisciplinary Care for Older Adults with Complex Needs: American Geriatrics Society Position Statement. Journal of the American Geriatrics Society 54:5, 849-852
CrossRef102
Pedro Abizanda Soler, Luis Romero Rizos, Carmen Luengo Márquez. (2006) Eficiencia de una unidad de geriatría en la gestión de camas hospitalarias. Revista Española de Geriatría y Gerontología 41:2, 143-144
CrossRef103
C. Seth Landefeld. (2006) Care of hospitalized older patients: Opportunities for hospital-based physicians. Journal of Hospital Medicine 1:1, 42-47
CrossRef104
Carla Graf. (2006) Functional Decline in Hospitalized Older Adults. AJN, American Journal of Nursing 106:1, 58-67
CrossRef105
Ewa Wressle, Viveka Filipsson, Lena Andersson, Beatrice Jacobsson, Karin Martinsson, Kristina Engel. (2006) Evaluation of occupational therapy interventions for elderly patients in Swedish acute care: A pilot study. Scandinavian Journal of Occupational Therapy 13:4, 203-210
CrossRef106
Ingvild Saltvedt, Marit Jordhøy, Ellen-Sofie Opdahl Mo, Peter Fayers, Stein Kaasa, Olav Sletvold. (2006) Randomised Trial of In-Hospital Geriatric Intervention: Impact on Function and Morale. Gerontology 52:4, 223-230
CrossRef107
Mathy Mezey, Eileen Quinlan, Susan Fairchild, Maria Vezina. (2006) Geriatric Competencies for RNs in Hospitals. Journal for Nurses in Staff Development (JNSD) 22:1, 2-10
CrossRef108
Jayna M Holroyd-Leduc, Laura P Sands, Steven R Counsell, Robert M Palmer, Denise M Kresevic, C Seth Landefeld. (2005) Risk Factors for Indwelling Urinary Catheterization among Older Hospitalized Patients without a Specific Medical Indication for Catheterization. Journal of Patient Safety 1:4, 201-207
CrossRef109
J.L. González-Guerrero, N. García-Mayolín, M. Valverde. (2005) Eficiencia de una unidad de Geriatría en la gestión de camas hospitalarias. Revista Española de Geriatría y Gerontología 40:6, 330-334
CrossRef110
C. Pedone, S. Ercolani, M. Catani, D. Maggio, C. Ruggiero, R. Quartesan, U. Senin, P. Mecocci, A. Cherubini, . (2005) Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60:12, 1576-1580
CrossRef111
R. Sean Morrison. (2005) Health Care System Factors Affecting End-of-Life Care. Journal of Palliative Medicine 8:supplement 1, s-79-s-87
CrossRef112
Laura P. Sands, C. Seth Landefeld, Sandra Moody Ayers, Kristine Yaffe, Robert Palmer, Richard Fortinsky, Steven R. Counsell, Kenneth E. Covinsky. (2005) Disparities Between Black and White Patients in Functional Improvement After Hospitalization for an Acute Illness. Journal of the American Geriatrics Society 53:10, 1811-1816
CrossRef113
Martine Extermann, Matti Aapro, Roberto Bernabei, Harvey Jay Cohen, Jean-Pierre Droz, Stuart Lichtman, Vincent Mor, Silvio Monfardini, Lazzaro Repetto, Liv Sørbye, Eva Topinkova. (2005) Use of comprehensive geriatric assessment in older cancer patients:. Critical Reviews in Oncology/Hematology 55:3, 241-252
CrossRef114
R. Rozzini, T. Sabatini, A. Cassinadri, S. Boffelli, M. Ferri, P. Barbisoni, G. B. Frisoni, M. Trabucchi. (2005) Relationship Between Functional Loss Before Hospital Admission and Mortality in Elderly Persons With Medical Illness. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60:9, 1180-1183
CrossRef115
Nathan E. Goldstein, R. Sean Morrison. (2005) The Intersection Between Geriatrics and Palliative Care: A Call for a New Research Agenda. Journal of the American Geriatrics Society 53:9, 1593-1598
CrossRef116
C. M. Boyd, Q.-L. Xue, J. M. Guralnik, L. P. Fried. (2005) Hospitalization and Development of Dependence in Activities of Daily Living in a Cohort of Disabled Older Women: The Women's Health and Aging Study I. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60:7, 888-893
CrossRef117
(2005) Caring for Older Americans: The Future of Geriatric Medicine. Journal of the American Geriatrics Society 53:S6, S245-S256
CrossRef118
Joseph H. Flaherty, Syed H. Tariq. (2005) RESPONSE LETTER TO DR. ROZZINI ET AL.. Journal of the American Geriatrics Society 53:5, 915-916
CrossRef119
Renzo Rozzini, Tony Sabatini, Marco Trabucchi. (2005) DO WE NEED DELIRIUM UNITS?. Journal of the American Geriatrics Society 53:5, 914-915
CrossRef120
J. Herrera. (2005) Los equipos de valoración y cuidados geriátricos: expectativas defraudadas. Revista Española de Geriatría y Gerontología 40:2, 120-125
CrossRef121
Brian C. Scanlan. (2005) The Value of Comprehensive Geriatric Assessment. Care Management Journals 6:1, 2-8
CrossRef122
D. Raveh, L. Gratch, A.M. Yinnon, M. Sonnenblick. (2005) Demographic and clinical characteristics of patients admitted to medical departments. Journal of Evaluation in Clinical Practice 11:1, 33-44
CrossRef123
Cathy M. Cruise, Mathew H.M. Lee. (2005) Delivery of rehabilitation services to people aging with a disability. Physical Medicine and Rehabilitation Clinics of North America 16:1, 267-284
CrossRef124
Renzo Rozzini, Tony Sabatini, Marco Trabucchi. (2005) DIAGNOSIS RELATED GROUPS AND HOSPITAL COSTS IN ELDERLY DEPENDENT PATIENTS. Journal of the American Geriatrics Society 53:1, 174-175
CrossRef125
Patrizia Mecocci, Eva von Strauss, Antonio Cherubini, Sara Ercolani, Elena Mariani, Umberto Senin, Bengt Winblad, Laura Fratiglioni. (2005) Cognitive Impairment Is the Major Risk Factor for Development of Geriatric Syndromes during Hospitalization: Results from the GIFA Study. Dementia and Geriatric Cognitive Disorders 20:4, 262-269
CrossRef126
Frances Kam Yuet Wong, Susan Chow, Katherine Chang, Albert Lee, Jiexin Liu. (2004) Effects of nurse follow-up on emergency room revisits: a randomized controlled trial. Social Science & Medicine 59:11, 2207-2218
CrossRef127
PD Griffiths, MH Edwards, A Forbes, RL Harris, G Ritchie, Peter Griffiths. 2004. Effectiveness of intermediate care in nursing-led in-patient units. .
CrossRef128
Mathy Mezey, Mia Kobayashi, Sheryl Grossman, Adolfo Firpo, Terry Fulmer, Ethel Mitty. (2004) Nurses Improving Care to Health System Elders (NICHE). JONA: The Journal of Nursing Administration 34:10, 451-457
CrossRef129
Olga H. Torres, Jose Muñoz, Domingo Ruiz, Josep Ris, Ignasi Gich, Eva Coma, Mercè GurguÃ, Guillermo Vázquez. (2004) Outcome Predictors of Pneumonia in Elderly Patients: Importance of Functional Assessment. Journal of the American Geriatrics Society 52:10, 1603-1609
CrossRef130
Renzo Rozzini, Tony Sabatini, Marco Trabucchi, Anette H. Ranhoff. (2004) STROKE UNITS AND ACUTE CARE FOR ELDERS MODEL OF CARE. Journal of the American Geriatrics Society 52:9, 1587-1588
CrossRef131
David B. Reuben. (2004) Confronting the Geriatrician's Nightmare. Journal of the American Geriatrics Society 52:8, 1393-1394
CrossRef132
Deborah G Stewart, Edward M Phillips, Carol F Bodenheimer, David X Cifu. (2004) Geriatric rehabilitation. 2. Physiatric approach to the older adult. Archives of Physical Medicine and Rehabilitation 85, 7-11
CrossRef133
T. M. Gill, H. Allore, Z. Guo. (2004) The Deleterious Effects of Bed Rest Among Community-Living Older Persons. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:7, M755-M761
CrossRef134
D. K. Kiely, M. A. Bergmann, R. N. Jones, K. M. Murphy, E. J. Orav, E. R. Marcantonio. (2004) Characteristics Associated With Delirium Persistence Among Newly Admitted Post-Acute Facility Patients. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:4, M344-M349
CrossRef135
Sasha Shepperd, Julie Parkes, Jacqueline JM McClaran, Christopher Phillips, Sasha Shepperd. 2004. Discharge planning from hospital to home. .
CrossRef136
P. B. d. A. Andreoli. (2003) A Systematic Review of Studies of the Cost-Effectiveness of Mental Health Consultation-Liaison Interventions in General Hospitals. Psychosomatics 44:6, 499-507
CrossRef137
Kyle R. Allen, Susan E. Hazelett, Robert R. Palmer, David G. Jarjoura, Glenda C. Wickstrom, Jan A. Weinhardt, Robert Lada, Carolyn M. Holder, Steven R. Counsell. (2003) Developing a Stroke Unit Using the Acute Care for Elders Intervention and Model of Care. Journal of the American Geriatrics Society 51:11, 1660-1667
CrossRef138
Darryl Wieland. (2003) The effectiveness and costs of comprehensive geriatric evaluation and management. Critical Reviews in Oncology/Hematology 48:2, 227-237
CrossRef139
D. Tsilimingras, A. K. Rosen, D. R. Berlowitz. (2003) Review Article: Patient Safety in Geriatrics: A Call for Action. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:9, M813-M819
CrossRef140
J. H. Flaherty, B. Stalvey, L. Rubenstein. (2003) Guest Editorial: A Consensus Statement on Nonemergent Medical Transportation Services for Older Persons. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:9, M826-M831
CrossRef141
Joseph H. Flaherty, Syed H. Tariq, Srinivasan Raghavan, Sanjeev Bakshi, Asif Moinuddin, John E. Morley. (2003) A Model for Managing Delirious Older Inpatients. Journal of the American Geriatrics Society 51:7, 1031-1035
CrossRef142
Amy L Byers, Heather Allore, Thomas M Gill, Peter N Peduzzi. (2003) Application of negative binomial modeling for discrete outcomes. Journal of Clinical Epidemiology 56:6, 559-564
CrossRef143
Makoto Tanaka. (2003) Multidisciplinary team approach for elderly patients. Geriatrics and Gerontology International 3:2, 69-72
CrossRef144
Luigi Ferrucci, Jack M. Guralnik, Chiara Cavazzini, Stefania Bandinelli, Fulvio Lauretani, Benedetta Bartali, Lazzaro Repetto, Dan L. Longo. (2003) The frailty syndrome: a critical issue in geriatric oncology. Critical Reviews in Oncology/Hematology 46:2, 127-137
CrossRef145
Robert A. Bonomo, Curtis J. Donskey, Jeffery L. Blumer, Andrea M. Hujer, Claudia K. Hoyenm, Michael R. Jacobs, Christopher C. Whalen, Robert A. Salata. (2003) Cefotaxime-Resistant Bacteria Colonizing Older People Admitted to an Acute Care Hospital. Journal of the American Geriatrics Society 51:4, 519-522
CrossRef146
Kenneth E. Covinsky, Robert M. Palmer, Richard H. Fortinsky, Steven R. Counsell, Anita L. Stewart, Denise Kresevic, Christopher J. Burant, C. Seth Landefeld. (2003) Loss of Independence in Activities of Daily Living in Older Adults Hospitalized with Medical Illnesses: Increased Vulnerability with Age. Journal of the American Geriatrics Society 51:4, 451-458
CrossRef147
R. Rozzini, T. Sabatini, M. Trabucchi. (2003) THE NETWORK FOR ELDERLY CARE IN ITALY: ONLY A CORRECT USE OF ACUTE WARDS ALLOWS AN OVERALL FUNCTIONING OF THE HEALTH CARE SYSTEM. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:2, M190-M191
CrossRef148
Chad E. Eric A. Boult Coleman. (2003) Diffusing Our Innovations. Journal of the American Geriatrics Society 51:1, 127-128
CrossRef149
Gustav From, Lone Mark Pedersen, Jette Hansen, Morten Christy, Thomas Gjørup, Niels Thorsgaard, Hans Perrild, Olaf Bonnevie, Anne Frølich. (2003) Evaluating two different methods of documenting care plans in medical records. Clinical Governance: An International Journal 8:2, 138-150
CrossRef150
Robert M Palmer, Steven R Counsell, Seth C Landefeld. (2003) Acute Care for Elders Units. Disease Management & Health Outcomes 11:8, 507-517
CrossRef151
L. P. Sands, K. Yaffe, K. Covinsky, M.-M. Chren, S. Counsell, R. Palmer, R. Fortinsky, C. S. Landefeld. (2003) Cognitive Screening Predicts Magnitude of Functional Recovery From Admission to 3 Months After Discharge in Hospitalized Elders. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:1, M37-M45
CrossRef152
E. F. Binder, R. L. Kruse, A. K. Sherman, R. Madsen, S. C. Zweig, R. D'Agostino, D. R. Mehr. (2003) Predictors of Short-Term Functional Decline in Survivors of Nursing Home-Acquired Lower Respiratory Tract Infection. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:1, M60-M67
CrossRef153
Anita Kozyrskyj, Carolyn De Coster, Philip St John. (2002) Long Stay Patients In Winnipeg Acute Care Hospitals. Healthcare Management Forum 15:4, 15-20
CrossRef154
J. H. Flaherty. (2002) The Adolescence of Geriatrics. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:12, M808-M811
CrossRef155
R. L. Kane. (2002) The Future History of Geriatrics: Geriatrics at the Crossroads. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:12, M803-M805
CrossRef156
Jack M. Guralnik, Luigi Ferrucci. (2002) Underestimation of Disability Occurrence in Epidemiological Studies of Older People: Is Research on Disability Still Alive?. Journal of the American Geriatrics Society 50:9, 1599-1601
CrossRef157
Eileen H Callahan, David C Thomas, Suzanne L Goldhirsch, Rosanne M Leipzig. (2002) Geriatric hospital medicine. Medical Clinics of North America 86:4, 707-729
CrossRef158
D. R. Thomas. (2002) Guest Editorial: Focus on Functional Decline in Hospitalized Older Adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:9, M567-M568
CrossRef159
L. P. Sands, K. Yaffe, L.-Y. Lui, A. Stewart, C. Eng, K. Covinsky. (2002) The Effects of Acute Illness on ADL Decline Over 1 Year in Frail Older Adults With and Without Cognitive Impairment. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:7, M449-M454
CrossRef160
M. Mezey, T. Fulmer. (2002) The Future History of Gerontological Nursing. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:7, M438-M441
CrossRef161
Ingvild Saltvedt, Ellen-Sofie Opdahl Mo, Peter Fayers, Stein Kaasa, Olav Sletvold. (2002) Reduced Mortality in Treating Acutely Sick, Frail Older Patients in a Geriatric Evaluation and Management Unit. A Prospective Randomized Trial. Journal of the American Geriatrics Society 50:5, 792-798
CrossRef162
David B. Reuben. (2002) Organizational Interventions to Improve Health Outcomes of Older Persons. Medical Care 40:5, 416-428
CrossRef163
W. M. Bortz. (2002) A Conceptual Framework of Frailty: A Review. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:5, M283-M288
CrossRef164
Cohen, Harvey Jay, Feussner, John R., Weinberger, Morris, Carnes, Molly, Hamdy, Ronald C., Hsieh, Frank, Phibbs, Ciaran, Courtney, Donald, Lyles, Kenneth W., May, Conrad, McMurtry, Cynthia, Pennypacker, Leslye, Smith, David M., Ainslie, Nina, Hornick, Thomas, Brodkin, Kayla, Lavori, Philip, . (2002) A Controlled Trial of Inpatient and Outpatient Geriatric Evaluation and Management. New England Journal of Medicine 346:12, 905-912
Full Text165
Nancy G. Kutner, Sarbjit V. Jassal. (2002) Quality of Life and Rehabilitation of Elderly Dialysis Patients. Seminars in Dialysis 15:2, 107-112
CrossRef166
Brian D. Hart, Jennifer Birkas, Mark Lachmann, Leslie Saunders. (2002) Promoting Positive Outcomes for Elderly Persons in the Hospital: Prevention and Risk Factor Modification. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 13:1, 22-33
CrossRef167
Muriel R. Gillick. (2002) Do We Need to Create Geriatric Hospitals?. Journal of the American Geriatrics Society 50:1, 174-177
CrossRef168
Jack M. Guralnik, Luigi Ferrucci, Jennifer L. Balfour, Stefano Volpato, Angelo Di Iorio. (2001) Progressive versus Catastrophic Loss of the Ability to Walk: Implications for the Prevention of Mobility Loss. Journal of the American Geriatrics Society 49:11, 1463-1470
CrossRef169
Sidney T. Bogardus, Virginia Towle, Christianna S. Williams, Mayur M. Desai, Sharon Inouye. (2001) What Does the Medical Record Reveal about Functional Status?. A Comparison of Medical Record and Interview Data. Journal of General Internal Medicine 16:11, 728-736
CrossRef170
Simon Lewin, Zoe Skea, Vikki A Entwistle, Merrick Zwarenstein, Judy Dick, Simon Lewin. 2001. Interventions for providers to promote a patient-centred approach in clinical consultations. .
CrossRef171
Neil Winawer. (2001) POSTOPERATIVE DELIRIUM. Medical Clinics of North America 85:5, 1229-1239
CrossRef172
Rosanne M. Leipzig, Cathy S. Berkman, Sandra Ramirez-Coronado, Monica Pignotti. (2001) Integrating Housestaff into a Geriatric Inpatient Interdisciplinary Team. Gerontology & Geriatrics Education 21:3, 63-72
CrossRef173
Craig Whitehead, Rachel Wundke, Lou Williamson, Paul Finucane. (2001) Accessing residential care from an acute hospital: Can we be more efficient?. Journal of Quality in Clinical Practice 21:1-2, 9-12
CrossRef174
Cathy S. Berkman, Rosanne M. Leipzig, Sherry A. Greenberg, Sharon K. Inouye. (2001) Methodologic Issues in Conducting Research on Hospitalized Older People. Journal of the American Geriatrics Society 49:2, 172-178
CrossRef175
Madeline H. Schmitt. (2001) Collaboration improves the quality of care: methodological challenges and evidence from US health care research. Journal of Interprofessional Care 15:1, 47-66
CrossRef176
Thomas J. Marrie. (2000) Community‐Acquired Pneumonia in the Elderly. Clinical Infectious Diseases 31:4, 1066-1078
CrossRef177
Kenneth E. Covinsky. (2000) Bringing a Generalist Approach to the Problems of Older Patients. Journal of General Internal Medicine 15:9, 673-674
CrossRef178
J Parkes, S Shepperd. 2000. Discharge planning from hospital to home. .
CrossRef179
Z. M. Pine, B. Gurland, M.-M. Chren. (2000) Report of Having Slowed Down: Evidence for the Validity of a New Way to Inquire About Mild Disability in Elders. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 55:7, M378-M383
CrossRef180
Merrick Zwarenstein, Wendy Bryant, Merrick Zwarenstein. 2000. Interventions to promote collaboration between nurses and doctors. .
CrossRef181
Sanjeev Bakshi, Douglas K. Miller. (1999) ASSESSMENT OF THE AGING MAN. Medical Clinics of North America 83:5, 1131-1149
CrossRef182
I. Scott. (1999) Optimising care of the hospitalised elderly. A literature review and suggestions for future research. Australian and New Zealand Journal of Medicine 29:2, 254-264
CrossRef183
Lois H Thomas, Nicky A Cullum, Elaine McColl, Nikki Rousseau, Jennifer Soutter, Nick Steen, Lois H Thomas. 1999. Guidelines in professions allied to medicine. .
CrossRef184
Olivier Despond, Eric Buchser, Anne-Lise Sprunger, Dorith Sloutkis. (1999) Influence of patient's dressing on spontaneous physical activity and length of hospital stay in surgical patients. Sozial- und Präventivmedizin 44:1, 8-13
CrossRef185
Diane P Martin, Paula Diehr, Douglas A Conrad, Julie Hunt Davis, Richard Leickly, Edward B Perrin. (1998) Randomized trial of a patient-centered hospital unit. Patient Education and Counseling 34:2, 125-133
CrossRef186
Sandra B. Dunbar, Laura H. Jacobson, Christi Deaton. (1998) Heart Failure: Strategies to Enhance Patient Self-Management. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 9:2, 244-256
CrossRef187
Sharon K. Inouye, Julia T. Rushing, Marquis D. Foreman, Robert M. Palmer, Peter Pompei. (1998) Does Delirium Contribute to Poor Hospital Outcomes? A Three-Site Epidemiologic Study. Journal of General Internal Medicine 13:4, 234-242
CrossRef188
Kenneth E. Covinsky, Gary E. Rosenthal, Mary-Margaret Chren, Amy C. Justice, Richard H. Fortinsky, Robert M. Palmer, C. Seth Landefeld. (1998) The Relation Between Health Status Changes and Patient Satisfaction in Older Hospitalized Medical Patients. Journal of General Internal Medicine 13:4, 223-229
CrossRef189
David G. Fairchild, Mairead L. Hickey, E. Francis Cook, Rita M. McCarthy, Laura P. Rossi, Samantha C. Timmons, Carol M. Mangione, Thomas H. Lee. (1998) A Prediction Rule for the Use of Postdischarge Medical Services. Journal of General Internal Medicine 13:2, 98-105
CrossRef190
Jeanne St. Pierre. (1998) Functional Decline in Hospitalized Elders: Preventive Nursing Measures. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 9:1, 109-118
CrossRef191
A.G. Johnson, D.G. Le Couteur, P. Martin, A. Taylor. (1997) A Prospective Evaluation of Discharge Efficiency in a University General Medical Unit. Australasian Journal on Ageing 16:4, 158-160
CrossRef192
Pamela H. Mitchell, Jan Heinrich, Patricia Moritz, Ada Sue Hinshaw. (1997) Outcome Measures and Care Delivery Systems. Medical Care 35:Supplement, NS1-NS5
CrossRef193
Suzanne Bakken Henry, William L. Holzemer. (1997) Achievement of Appropriate Self-Care. Medical Care 35:Supplement, NS33-NS40
CrossRef194
H Hemingway, A Nicholson, M Stafford, R Roberts, M Marmot. (1997) The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: the Whitehall II Study.. American Journal of Public Health 87:9, 1484-1490
CrossRef195
Ron L. Evans, Richard T. Connis, Jodie K. Haselkorn. (1997) Evaluating Rehabilitation Medicine: Effects on Survival, Function, and Home Care. Home Health Care Services Quarterly 16:3, 35-53
CrossRef196
Alan M. Jette. (1997) Disablement Outcomes in Geriatric Rehabilitation. Medical Care 35:Supplement, JS28-JS37
CrossRef197
Kenneth E. Covinsky, Amy C. Justice, Gary E. Rosenthal, Robert M. Palmer, C. Seth Landefeld. (1997) Measuring Prognosis and Case Mix in Hospitalized Elders The Importance of Functional Status. Journal of General Internal Medicine 12:4, 203-208
CrossRef198
Cheves M. Smythe. (1997) Some Lessons Learned in the Care of the Elderly. Epilepsia 38:s4, S50-S54
CrossRef199
(1996) Australian Society for Geriatric Medicine Position Statement Geriatric Services in General Hospitals. Australasian Journal on Ageing 15:2, 73-77
CrossRef200
Nancy G. Kutner. (1996) Rehabilitation of the elderly patient on dialysis. Geriatric Nephrology and Urology 6:2, 81-88
CrossRef201
Gary Naglie, Michael Gordon. (1995) The coming of age of geriatric care. The Lancet 346, S7
CrossRef202
Manton, Kenneth G., Vaupel, James W., . (1995) Survival after the Age of 80 in the United States, Sweden, France, England, and Japan. New England Journal of Medicine 333:18, 1232-1235
Full Text203
Campion, Edward W., . (1995) The Value of Geriatric Interventions. New England Journal of Medicine 332:20, 1376-1378
Full Text
